More detailed criteria about patients who showed bad prognosis during follow-up in spite of negative interim PET are summarized in Table 6. Google Scholar, Fan Y-G, Zhang Y, Yang Z, Ying Z, Zhou N, Liu C, Song Y-Q, Zhu J, Wang X-J (2017) Evaluating early interim fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography with the SUVmax-liver-based interpretation for predicting the outcome in diffuse large B-cell lymphoma. Med. 18F-fluoro-2-deoxyglucosepositron emission tomography has been found to be useful in lymphoma staging, prediction of prognosis and risk stratification of lymphoma patients. Oct 24, 2018. . The follow-up period for all patients ranged between 6 and 40 months with a mean of 24 months. Graduated from ENSAT (national agronomic school of Toulouse) in plant sciences in 2018, I pursued a CIFRE doctorate under contract with SunAgri and INRAE in Avignon between 2019 and 2022. What is lymphoma score? VOI is identified and drawn, for each lesion either nodal or extra-nodal lesion automatically for generating 3D iso-count contours using a fixed threshold of 40% of the SUVmax (V40%). Three patients had biopsy-proven relapses 3-9 months after completion of chemotherapy. Egyptian Journal of Radiology and Nuclear Medicine Blood. Positron emission tomography (PET) scan: The PET scan will light up the nodule if it is rapidly growing or active. A score of 4 or 5 on the International Prognostic Index indicating that an individual has a high risk of progression of non-Hodgkin lymphoma and a 5 year survival of 32%. Li YH, Zhao YM, Jiang YL, Tang S, Chen MT, Xiao ZZ, Fan W, Hu YY, Zhang X. Eur J Nucl Med Mol Imaging. FDG uptake refers to the amount of radiotracer uptake. The diffuse large B-cell lymphoma prognosis calculator estimates the overall & progression-free survival with the use of the revised IPI score for lymphoma. Clinicopathological criteria are summarized in Table 2. statement and A previous study investigating the impact of posttreatment Deauville score on survival in patients with nodal PTCL showed that a posttreatment Deauville score of 4 or 5 is predictive of poor survival . Springer Nature. Ratio between target lesion and liver SUVmax (rDS/rPET). Qualitative data were expressed as frequency and percentage. However, the prognostic value of posttreatment Deauville score has not been well investigated in nodal PTCL. However, it is a highly treatable disease and the symptoms can be controlled and even reduced with proper treatment and care. bouquinistes restaurant paris; private client direct jp morgan; show-off crossword clue 6 letters; thermage near illinois; 2012 kia sportage camshaft position sensor location We performed a The uptake value is represented by pixel or voxel intensity value in the ROI of the image, which is then converted into the activity concentration. From the 89 children with proved extra-nodal lymphoma, 66 (74.2%) were males and 23 (25.8%) were females. "Score 3 should be interpreted according to the clinical context but in many Hodgkin Lymphoma patients indicates a good prognosis with standard treatment." History. Chemotherapy kills cells that multiply quickly, such as lymphoma cells. The DS interim negative group included 65 patients, while the positive group included 24 patients. The scale ranges from 1 to 5, where 1 is best and 5 is the worst. The company was founded in 1997 by late Microsoft co-founder Paul Allen and his sister Jody Allen.It closed in 2021. The tonsils, Waldeyers ring and spleen are considered nodal tissue for staging. Stage III-IV: There is cancer in lymph node areas on both sides of the diaphragm (stage III), or the cancer has spread throughout the body beyond the lymph nodes (stage IV). Our study highlighted the prognostic value of both methods and shows that the rDS could be put in consideration as a more accurate prognostic factor in those children with lymphoma. Biggi A, Gallamini A, Chauvie S et-al. results are evaluated on a 5-point Deauville scale, with scores of 4 or 5 indicating uptake that is greater than the liver.13 Practically speaking, patients escalating therapy should interpret a Deauville score of 1 to 3 as negative, whereas those de-escalating therapy should consider a Deauville score of 1 to 2 as negative. [9], on 181 patients with DLBCL, ROC analysis revealed the optimal cutoff value to be 1.4-fold of SUVmax-liver on iPET4 which is higher than our cutoff point that can be explained by different timing of interim PET (iPET4 not iPET2) that may be affected by posttherapy inflammatory changes, while Fan et al. If the cancer spreads regionally, the 5-year survival rate is 94%. We recommend using this easier rPET semiquantitative parameter for interim PET assessment that could be more confirmed by making larger studies with more homogenous sample regarding histopathological subtypes and chemotherapy lines that may help in intra-examination normalization. What is a good Deauville score? The prognostic value of PET/CT evaluation with Deauville score on the recurrence and survival in diffuse large B-cell lymphoma: a multi-institutional study of KROG 17-02 Clin Exp Metastasis . The existing statistical procedures for DOR are valid when certain model assumptions are correctly specified. Background: Total body and long-axial field-of-view (LAFOV) PET/CT represent visionary innovations in imaging enabling either improved image quality, reduction in injected activity-dose or decreased acquisition time. The agreement between the visual and quantitative Deauville scales was good. Before 2015 Jul;170(2):185-91. doi: 10.1111/bjh.13420. The ROC analysis for rDS as a predictor of progression showed an optimal cut-point of 1.25. In the DS interim negative group, male children were 50/65 patients (representing 77% of interim negative group), while in the interim positive group, male children were 17/24 (representing 71% of interim positive group). Most articles have considered the utility of FDG (fluorine-18 combined with deoxy-glucose) which is the most used radiotracer in clinical practice. Clinical information regarding recent treatments was investigated to help in differentiation between treatment-induced increased hematopoiesis and true disease. When evaluated by the Deauville criteria, patients with an interim PET with a score of 1-3 (n=83) had a median OS and EFS of 104 months and 64 months compared to those with a score of 4-5 (n=16) who had a median OS and EFS of 19 and 11 months (p<0.001). Accurate interpretation of early response evaluation PET (interim PET) is crucial for achieving the best management strategy for lymphoma patients; however, it is still a subject of ongoing debate. Results: A totally 145 patients with a mean age of 71.469.26, were evaluated. The company financed and co-produced films with directors such as Martin Scorsese, Clint Eastwood and Robert Redford. Metabolic parameters of the highest FDG-avid lesion were recorded for all studied cases as given in Table 4. Pediatr Rev 38(9):410423. Dabaja BS, Phan J, Mawlawi O, Medeiros LJ, Etzel C, Liang FW, Podoloff D, Oki Y, Hagemeister FB, Chuang H, Fayad LE, Westin JR, Shihadeh F, Allen PK, Wogan CF, Rodriguez MA. 6. Tailoring treatment in patients with Hodgkin lymphoma (HL) is paramount to maximize outcomes while avoiding unnecessary toxicity. We recommend making further studies with larger sample size, with more homogenous samples regarding histopathological subtypes and chemotherapy lines to confirm these results. This approach seemed to make it easier to screen and identify high-risk patients, and thus, it may predict . Diffuse large B-cell lymphoma, or DLBCL, is a cancer that starts in white blood cells called lymphocytes. prognosis in HL, DLBCL, and follicular lymphomas . On the contrary, Yao et al. It takes advantage of two reference points of the individual patient,which have demonstrated relatively constant uptake on serial imaging. An official website of the United States government. PMC sharing sensitive information, make sure youre on a federal In our study, patients with iPET Deauville 1-3, 4 and 5 not only had different survival time, but also had different eCRR to R-CHOP regimen. What is the difference between parietal cells and chief cells? The visual interpretation of this study using 5P-DS was positive (score 4) as left femoral activity was higher than that of liver, while it was negative using rDS (rDS=1.05) which is less than the cutoff point (liver max~2.5). The rDS approach uses the strictly quantitative target-to-liver SUVmax ratio, without any connection to a visual analysis. Federal government websites often end in .gov or .mil. Deauville is a posh seaside resort in Normandy, France. These results are very close to the results of Annunziata et al. Receiver operating characteristic approach was applied to identify the optimal cut-point of rDS with respect to response to therapy and prognosis, and the prognostic significance of rDS was compared with 5p-DS. Br J Haematol. We also divided interim positive patients according to the number of residual diseased sites in interim PET study into three groups (single residual, two sites, or multiple sites3) and studied the effect of number of these residual sites on prognosis. A risk stratification model for nodal peripheral T-cell lymphomas based on the NCCN-IPI and posttreatment Deauville score. The tonsils, Waldeyers ring and spleen are considered nodal tissue for staging. Non-Hodgkin lymphoma (NHD) was found in 55 patients (61.8%), while Hodgkin lymphoma was found in the remaining 34 patients (38.2%). Progression-free survival (PFS) was well stratified according to a visual assessment of interim PET/CT using 5-PS (p < 0.001). Response to therapy in interim negative and positive group. The interpretation of this study using DS showing a positive result score 4 as sternal activity is higher than that of liver, while rDS=1.22 which is less than the cutoff point (liver max 1.8). Moreover, this study has some limitations including the small number of patients, heterogeneity of lymphoma subtypes, and first-line treatment modalities used that could affect the outcome. Positron emission tomography (PET) scan: The PET scan will light up the nodule if it is rapidly growing or active. Also, the 5p-DS and rPET were in agreement with most of the patients (87/89, 97.8%). Each FDG-avid (or previously FDG-avid) lesion is rated independently: no uptake or no residual uptake (when used interim). PMD Score 4 or 5 with an increase in uptake from baseline and /or New FDG-avid foci consistent with lymphoma At interim or end of treatment *Score 3 in many patients indicates a good prognosis with standard treatment. Methods Thirty-nine patients (20 males,19 females;median 58 (23-85) years) with pathologically confirmed DLBCL were retrospectively analyzed from January 2009 to April 2015. Egypt J Radiol Nucl Med 53, 217 (2022). 54 (12): 2631-8. Chin J Cancer Res 29(1):5765. It included 92 children with pathologically proved lymphoma. MeSH Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. The maximum standardized uptake value (SUVmax) is widely used for measuring the uptake of FDG by malignant tissue (Gambhir 2002). Score 3 should be interpreted according to the clinical context but in many Hodgkin Lymphoma patients indicates a good prognosis with standard treatment. A: Radiation pneumonitis commonly occurs after radiation therapy to the lung. I'm in remission and my last score was like a 4. 7. Bookshelf 4. Your nurse will give you doxorubicin (a red fluid) as an injection directly into your vein with a drip (infusion) to flush it through. Overall, most cases of non-Hodgkin lymphoma are considered very treatable. Consequently, the rPET cut-point of 1.25 seems to be accurate to identify patients with aggressive disease. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. . Of the 10 patients with an end-of-therapy Deauville score of 4 or 5, four had a diagnosis of relapse or refractory disease based on end-ofchemotherapy imaging alone. How do you find the coefficient of permeability? Among patients in partial remission or stable disease at day 30, the authors observed two subgroups with significantly different prognosis; patients with Deauville score (DS)4-5 and a concomitant reduction of standardized uptake value (SUV) mean had higher probability of long-lasting response than those with DS4-5 and an increase of SUV mean. In our schema, a complete metabolic response (CMR) is defined as a return of FDG uptake in previously documented lesions to a level equivalent to, or less than, residual radioactivity in normal tissues within the organ in question. Your doctor can use this information to help diagnose, monitor or treat your condition. Deauville score versus ratio Deauville score in the interpretation of interim 18F-FDG PET-CT and in prediction of outcome in children with FDG-avid extra-nodal lymphomas, https://doi.org/10.1186/s43055-022-00899-6, Egyptian Journal of Radiology and Nuclear Medicine, https://doi.org/10.1007/s00259-014-2973-6, https://doi.org/10.1007/s00259-014-2715-9, https://doi.org/10.1007/s00259-012-2280-z, https://doi.org/10.1080/10428190903040048, https://doi.org/10.1371/journal.pone.0211649, https://doi.org/10.21147/j.issn.1000-9604.2017.01.07, http://creativecommons.org/licenses/by/4.0/. Involved extra-nodal sites are illustrated in Table 3. Fluorine-18 is one of the several isotopes of fluorine that is routinely used in radiolabeling of biomolecules for PET; because of its positron emitting property and favorable half-life of 109.8 min. Lymphoma most often spreads to the liver, bone marrow, or lungs. Univariate survival analysis was performed using the Kaplan-Meier . For patients using the Deauville score PET-CT scan (n = 103), the percentage of PET-negative cases (Deauville score 1-3) was 91%. (Negative PET images are scored as 1 or 2 and positive PETs are scored as 3, 4 or 5, depending on the level of uptake.). 1 and 2). The Korean Radiation Oncology Group (KROG) assessed the value of Deauville score (DS) on 18F-fluorodeoxyglucose Positron emission tomography-computed tomography (FDG PET/CT) as a predictor of recurrence and survival after rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemotherapy in diffuse large B-cell lymphoma (DLBCL). Recently, a ratio between semiquantitative parameters (e.g., target lesion and liver SUV) has been proposed for interim FDG-PET/CT interpretation as it allows conversion of the visual qualitative scale to a continuous semiquantitative scale and permits evaluation of interim FDG-PET/CT through a well-determined semiquantitative-based cut-point [5]. 5 Point Scale /Deauville criteria 1. no uptake 2. uptake mediastinum . Hodgkin's lymphoma is a treatable cancer. Imaging. Elhamady, H.Y., Mostafa, H.M., Elsayed, H.F. et al. Both visual and semiquantitative interpretation methods were negative, and the patient was free till the last follow-up. Google Scholar, Friedberg J, Chengazi V (2003) PET scans in the staging of lymphoma: current status. Br J Haematol. 1left IIb cervical node, 2extensive upper abdominal involvement (periportal, peripancreatic, aortocaval, paraaortic, mesenteric nodes, heterogenous liver and PubMed Central Also, it helped to minimize the side effects of therapy without losing treatment efficacy and reduce the number of chemotherapy cycles to the optimum for each individual patient [2, 4]. CAS Other tracers are also used in PET to image the tissue concentration. https://doi.org/10.1200/JCO.2002.08.021, Hasenclever D, Kurch L, Mauz-Krholz C, Elsner A, Georgi T, Wallace H, Landman-Parker J, Moryl-Bujakowska A, Cepelov M, Karln J, lvarez Fernndez-Teijeiro A, Attarbaschi A, Foss A, Pears J, Hraskova A, Bergstrsser E, Beishuizen A, Uyttebroeck A, Schomerus E, Sabri O, Krholz D, Kluge R (2014) qPET - a quantitative extension of the Deauville scale to assess response in interim FDG-PET scans in lymphoma. [11] studied 119 adult patients with newly diagnosed DLBCL and found that a higher interim2 cutoff value of 1.6 achieves the highest specificity and makes more accurate reproducibility and outcome prediction. Score 3 should be interpreted according to the clinical context but in many Hodgkin Lymphoma patients indicates a good prognosis with standard treatment. The scale ranges from 1 to 5, where 1 is best and 5 is the worst. Fluorine-18 is one of the several isotopes of fluorine that is routinely used in radiolabeling of biomolecules for PET; because of its positron emitting property and favorable half-life of 109.8 min. Scores of 1 and 2 are considered to be negative and 4 and 5 are considered to be positive. Mol. Three patients were excluded from this study because one of them had tonsillar lymphoma (considered a nodal site), the second one had severe nasopharyngeal lymphoma with intracranial extension that needed urgent treatment without waiting for a baseline PET study, while the last child died after two cycles of CTH. Progression-free survival did not differ between scores 2, 3, and 4, whereas score 5 was associated with significantly worse outcome (visual scale: hazard . This ratio has some important technical and practical advantages over visual analysis as it is independent of the amount of administered activity and body weight; it also allows conversion of a visual qualitative scale (as 5p-DS) in a continuous semiquantitative scale through a well-determined semiquantitative-based cut-point [8, 9]. Positive bone marrow biopsy was found in 25 patients, 10 of them were negative in interim PET, while the rest of them were interim positive. Patients were instructed to fast for 46h before PET scanning. As a result, the group with the worst prognosis (a Deauville score \(\ge\) 4 and MTV \(\ge\) 158.16 cm \(^3\)) with progression-free took up 3.22 \(\%\) of the total patients within 2 years, yet 11.11 \(\%\) of the total progressive cases. Objective To investigate the prognostic value of SUV and Deauville 5-point scoring (5-PS) in patients with DLBCL. 41,44 (see HODG-5, page 759) If the Deauville score is 1 to 3, the treatment options include an additional 2 cycles of ABVD (if previously given, for a total . If the cancer is found in its earliest stages, the 5-year survival rate is 91%. A global group of dedicated editors oversee accuracy, consulting with expert advisers, and constantly reviewing additions. official website and that any information you provide is encrypted Conversely, only 31% of patients showed a residual uptake after therapy in FLs, mainly distributed among DS scores of 3 and 4. A log-rank test was used to compare the survival probabilities between the two groups. Articles are a collaborative effort to provide a single canonical page on all topics relevant to the practice of radiology. Scores of 1 and 2 are considered to be negative and 4 and 5 are considered to be positive. Mikhaeel NG, Cunningham D, Counsell N, McMillan A, Radford JA, Ardeshna KM, Lawrie A, Smith P, Clifton-Hadley L, O'Doherty MJ, Barrington SF. We retrospectively identified 128 patients with grade 1-3A FL who had an interim PET after 2-4 cycles of frontline CIT at 2 academic centers. In interim negative group, 41 patients had NHD, while the remaining 24 patients had HD. Adults more than 18years; lymphoma affecting only lymph nodes or lymphatic organs as spleen and Waldeyers ring; lymphoma subtypes that are not FDG avid at the initial staging; relapsing lymphoma even if associated with extra-nodal involvement; patients with no baseline or interim PET/CT studies; life-threatening impairment of organ function; diabetes mellitus; and those who have double primaries. FDG is widely used in PET scanning. progressive disease (PD): a Deauville score of 4 to 5 with increasing intensity compared to baseline or any interim scan and/or any new FDG-avid focus consistent with malignant lymphoma. Below are the 5-year relative survival rates for two common types of NHL - diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL) - based on people . Intravenous contrast media was given in some studies. In patients whose GIT showed diffuse activity, meticulous interpretation of other findings such as the presence or absence of bowel masses, accompanied nodal or extra-nodal lesions as well as history of inflammatory bowel disease is included for final suggestion. A joined analysis of two prospective randomized trials in newly diagnosed transplant-eligible MM (NDTEMM) patients applied for the first time the Deauville Scores (DS) to focal lesions (FS) and bone marrow uptake (BMS) and showed the liver background (DS < 4) to be the best cut-off to define PET negativity after therapy (Zamagni et al, ASH 2018). The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. Therefore, the present study aimed to evaluate the prognostic impact of interim 18 F-FDG PET/CT assessment according to the Deauville 5-PS score (DS) and SUVmax on survival outcomes of patients . Epub 2021 Oct 15. Among patients in partial remission or stable disease at day 30, the authors observed two subgroups with significantly different prognosis; patients with Deauville score (DS)4-5 and a concomitant reduction of standardized uptake value (SUV) mean had higher probability of long-lasting response than those with DS4-5 and an increase of SUV mean. 2014;32 (27): . OM performed the statistical analysis of data. Total lesion glycolysis (TLG): It was automatically calculated by multiplying the selected PET volume (MTV) on the investigated lesions as mentioned above by the SUVmean within that volume [TLG=MTV X SUV mean]. 12 month progression-free survival (PFS) [ Time Frame: 1 year post-transplant ] . Oncologist 8(5):438447, Article PET-CT study for a 15-year-old male child complaining rapidly growing anterior chest wall mass that was pathologically proved to be HL, nodular sclerosis type. Researchers are always looking for new methods to determine survival rates, especially among b cell lymphomas, because they are so common . Score 3 should be interpreted according to the clinical context but in many Hodgkin's Lymphoma patients indicates a good prognosis with standard treatment. The prognostic value of end-of-treatment FDG-PET/CT in diffuse large B cell lymphoma: comparison of visual Deauville criteria and a lesion-to-liver SUV, NCI CPTC Antibody Characterization Program, Eur J Nucl Med Mol Imaging. Also, there was a significant correlation between the number of residual diseased sites at interim PET and survival which could be explained by its reflection of the aggression and widespread of the disease and consequently poorer response to therapy. This camera integrates a PET scanner with a dual-section helical CT scanner and allows the acquisition of co-registered CT and PET images in one session. Med. The selection process included patients who fulfilled the criteria given below: Children less than 18years, with pathologically proved FDG avid either Hodgkin or non-Hodgkin lymphoma; patients with lymphomatous extra-nodal involvement either primary or secondary; and whole-body FDG PET/CT study done at initial staging and after two cycles of CTH. The purpose of this study was to evaluate the prognostic role of the semiquantitative ratio Deauville score (rDS), defined as the ratio between target lesion and liver maximum standardized uptake values in children with FDG-avid extra-nodal lymphomas, undergoing interim FDG-PET/CT, and to compare it with the 5-point Deauville score (5p-DS). Sedation was used in most of the patients. {"url":"/signup-modal-props.json?lang=us"}, Pfleger R, Bell D, Knipe H, et al. 56 The implementation of rituximab into the abbreviated regimen (ie, 3 cycles of R-CHOP + RT) further improved survival of these patients (4-year PFS 88% . Leuk Lymphoma 50(8):12571260. 1-2 points: Prognosis, Good (4-year PFS 80%, OS 79%) 3-5 points: Prognosis, Poor (4-year PFS 53%, OS 55%) The R-IPI doesn't recognize risk groups with a perceived B cell lymphoma survival rate of under 50%. Lesion-to-Liver SUVmax Ratio to Improve the Prognostic Value of the End of Treatment PET/CT in Diffuse Large B-Cell Lymphoma. FDG-PET-CT for staging and treatment response in both clinical routine and clinical trials using the Deauville 5ps is recommended in 2: whereas there have been proposed separate criteria for 2: It is a simple tool based on visual interpretation of FDG uptake. It is a fluorine isotope with a half life of approximately 110 minutes. Duration of response is the time from response (R) to progression/death (P/D). In both BM and FLs, a DS score of 4 (with liver as reference) provided the strongest prediction for PFS and OS. It can also show up in other areas of your body. You will then have dacarbazine as a drip over at least 30 minutes. Interestingly, with all 3 . We studied the effects of all studied clinical factors, such as the age, gender, pathological type/subtype, LDH, BM infiltration, B symptoms, different extra-nodal sites, number of involved extra-nodal sites in the initial PET study (single extra-nodal site, 2 extra-nodal sites, and >2 sites) as well as semiquantitative parameters in both initial and interim PET, on progression-free survival. Our study was approved by the ethical committee of Faculty of medicine, Cairo University, and the radiation safety committee at NCI had given approval for study design. (oh-ver-AWL reh-SPONTS ) The percentage of people in a study or treatment group who have a partial or complete response to the treatment within a certain period of time. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. Patients received an intravenous injection of 5.55 megabecquerel (MBq)/kg (0.15 milli-Curie/kg) body weight dose of 18F-FDG (minimum dose, 74MBq (2mCi). The visual method depends on visual comparison of FDG uptake between lesions and liver as a reference organ for activity and considered lesions with activity higher than liver to be positive, while the semiquantitative method depends on making a ratio between the most active lesion and liver SUVmax. Target lesions were classified as Deauville score 4 positive (DS4+) or negative (DS4) based on their SUVpeak and then segmented in NECT images. Graduated from ENSAT (national agronomic school of Toulouse) in plant sciences in 2018, I pursued a CIFRE doctorate under contract with SunAgri and INRAE in Avignon between 2019 and 2022. government site. Other substances may be used for PET scanning, depending on the purpose of the scan. Chi-square test (Fishers exact test) was used to examine the relation between qualitative variables. Patients with negative 5p-DS and patients with rDS<1.25 had a similar 3-year PFS (87%). Background: Total body and long-axial field-of-view (LAFOV) PET/CT represent visionary innovations in imaging enabling either improved image quality, reduction in injected activity-dose or decreased acquisition time. The aim of our study was to evaluate the prognostic role of the ratio between the SUVmax of the hottest target residual lesion and liver SUVmax (rPET/rDS) in children with FDG-avid lymphomas undergoing interim FDG-PET/CT during the first-line chemotherapy and to compare rPET with 5p-DS. According to the researchers, novel therapies, such as CAR T-cells should be considered in these patients. https://doi.org/10.1542/pir.2016-0152, Article